Introduction
The incidence of symptomatic cerebral infarction after minimally invasive cardiac surgery (MICS) was higher than that after median sternotomy because of the retrograde blood flow from the femoral artery1. However, as MICS techniques are more widely used, the incidence of symptomatic brain infarction due to retrograde perfusion via the femoral artery has decreased. Recent studies have shown that the incidence was similar to that after median sternotomy2. In Japan, the incidence rate of stroke after MICS is reported as 1.0% 3. At our institution, the incidence of symptomatic cerebral infarction after MICS was zero4.
The significance of symptomatic cerebral infarction after cardiac surgery has been discussed in some studies, and some reports showed that silent brain infarction (SBI) also poses a risk of postoperative delirium 5. In addition, some studies have indicated that it may accelerate the development of vascular dementia6, which is an important clinical factor that can affect quality of life. The incidence rates of SBI are 29% after median sternotomy 5 and 29% after coronary angiography and stenting 7. This result indicates that the incidence of SBI is not low. However, no previous report has provided detailed information about SBI after MICS with retrograde perfusion via femoral cannulation.
In this study, the detailed characteristics of SBI after MICS were evaluated on head magnetic resonance imaging (MRI).